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The patient's pulse is faint and choppy. Erroneous use of sweating or purging methods constitutes a mistake. (A faint pulse indicates Qi deficiency, while a choppy pulse indicates Blood deficiency. Neither sweating nor purging should be employed in these cases. If purging is followed by sweating, both Ying [Nutritive] and Wei [Defensive] Qi become deficient, resulting in fever.)

If sweating leads to Yang collapse, aversion to cold ensues; if subsequent purging causes Yin depletion, heat becomes extreme. (When Yin is deficient, Yang inevitably congregates within. Since purging depletes Yin, Yang enters the Yin aspect, causing heat internally and externally. As stated in Su Wen: "Yang deficiency results in external heat; Yin deficiency results in internal heat," hence the extreme heat.) The most contraindicated scenario is when both Yin and Yang are already deficient; if the heat persists, the condition becomes critical. Additionally, there are relapse due to exertion [Lao Fu] and relapse due to diet [Shi Fu]; neglecting proper regulation, treatment, and nursing exacerbates the issue. (After purging, the body should cool down. If fever recurs after purging, it is not only due to erroneous sweating or purging but also involves Lao Fu and Shi Fu. Lao Fu refers to physical exertion after illness; Shi Fu refers to overeating, caused by failure in proper care and regulation.)

Upon recent recovery, Qi and Blood remain weak and emaciated; relapse due to exertion generates heat and lethargy. (Relapse due to exertion manifests as weakness and shortness of breath.) If the Spleen and Stomach are still weak and food intake is excessive, relapse due to diet causes fever and anorexia. (Relapse due to diet manifests as fever, vomiting, and aversion to the smell of food.) Xiao Chai Hu Zhi Shi Zhi Zi Tang (Minor Bupleurum, Immature Bitter Orange, and Gardenia Decoction) should be used with careful deliberation for these conditions.

Aversion to cold accompanied by fever occurs in the Yang meridians; absence of fever with aversion to cold indicates onset in the Yin meridians. (Zhang Zhongjing stated: "Fever with aversion to cold indicates onset in Yang; absence of fever with aversion to cold indicates onset in Yin.") Yang-onset diseases are suitable for sweating therapy using Ephedra-based formulas; Yin-onset diseases are suitable for warming and regulating Middle Jiao therapies like Lizhong Tang. (Onset in Yang is suitable for Guizhi Tang, Mahuang Tang, or Qinglong Tang variants; onset in Yin is suitable for Sini Tang or Lizhong Tang.) "Se se" [shivering] aversion to cold is a Guizhi Tang syndrome. (Zhang Zhongjing stated: "Shivering aversion to cold and mild fever constitute a Guizhi Tang syndrome.") Aversion to cold after sweating indicates deficiency and intolerance. (Aversion to cold post-sweating signifies Qi/Yang deficiency.) A faint pulse with aversion to cold contraindicates purging; slight sweating may still be appropriate, avoiding deep sweating. (A faint pulse contraindicates purging. Even if sweating is indicated, it should be mild.) There are also cases of head sweating with aversion to cold, where Chai Hu Jia Guizhi Tang (Bupleurum plus Cinnamon Twig Decoction) is invaluable. (Head sweating with aversion to cold is treated by Zhang Zhongjing using Chai Hu Jia Guizhi Tang.) After sweating, if aversion to cold persists with epigastric fullness [Xin Xia Pi], Fuzi Xie Xin Tang (Aconite Draining the Epigastrium Decoction) adds Fuzi. (Zhang Zhongjing stated: "Epigastric fullness accompanied by aversion to cold and sweating is treated with Fuzi Xie Xin Tang." See Formula 18.)